title: Inadequacy of present polyspecific anti snakevenom - a study from central Kerala.
abstract: OBJECTIVE
  To study the cause for prolonged coagulation profile and death in properly treated hemotoxic snake envenomation and the bad prognostic indicators in snake envenomation.
  
  
  METHODS
  This was a hospital based prospective analytical study. All snake bites with envenomation from 2006 through 2009 were clinically analysed at the time of admission. They were treated with standard treatment protocol. Snakes brought were preserved, identified and correlated with clinical details.
  
  
  RESULTS
  Of the 73 envenomation patients registered, 66 (90.4%) were hemotoxic envenomation, in which 14 (19.2%) had late recovery and 11 (15.1%) expired mainly due to hemorrhagic complication. The incidence of late recovery and mortality is higher compared to other Indian studies. Ten snakes were brought during the period along with the victims. Three of them were identified as hump nosed pit vipers, of which two victims had late recovery and one expired.
  
  
  CONCLUSIONS
  Hump nosed pit viper envenomation is not rare in Kerala and can cause death, unlike the earlier belief. Available anti snake venoms does not cover pit viper. So, antivenom for this snake is urgently required.
authors.affiliation: Department of Pediatrics, Government Medical College, Kottayam, Kerala, India. vkumarbabu@gmail.com
authors.forename: Veerendra
authors.initials: V
authors.lastname: Kumar
authors.forename: P
authors.initials: P
authors.lastname: Sabitha
mesh_terms: D000818:Animals; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000401:mortality*; D002648:Child; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality; D006801:Humans; D007194:India; D011446:Prospective Studies; D012909:Snake Bites / Q000150:complications*; D012911:Snakes